To find out if they could predict how long an older person will continue to live, Duke University researchers used 1507 blood samples and lifestyle data from participants in the D-EPESE study that was conducted in New Haven, CT, in 1992. Participants were at least 71 years old when the study started, and the Duke researchers counted their years to death over the following 27 years (eBioMedicine, Sept 28, 2022;85(3):104292). The strongest predictors of longevity were high levels of small LDL particles and low levels of large particle HDL cholesterol (described below), and smoking history. Their findings are particularly dependable because their blood was drawn in 1992, when fewer people were taking drugs such as statins that would make tests of blood lipid levels less significant. Other predictors of longevity included evidence of physical and mental activity.
People over 70 years of age were more likely to live at least 10 years longer if they had the following lifestyle factors:
• Ability to groom themselves. Lack of the motor control required for personal grooming was a very strong predictor of a shorter life.
• Ability to perform daily tasks such as grocery shopping and housework (Rosow-Breslau ability to do heavy housework test).
• Being a non-smoker.
• Having a high score on a cognitive function test (Short Portable Mental Status Questionnaire or SPMSQ).
• Exercising regularly. The greater the frequency and intensity of exercise, the more likely a person was to live longer.
Blood Test Factors
Blood test results associated with a longer life included:
• Having high levels of large particle HDL and low levels of small particle LDL cholesterol, total protein, albumin, and/or percentage of normal lymphocytes
• Having low normal levels of GlycA (a marker of inflammation), creatinine (kidney function) and/or GGT (liver test)
Large Particle HDL: The Most Reliable Predictor of Longevity
Of all the blood tests in the study, having high concentrations of large HDL particles (<9 nm diameter) was the best predictor of longevity. The standard tests for lipids used by most doctors today (total cholesterol, HDL, LDL and triglycerides) were not as dependable in predicting lifespan as the test for large size HDL particles.
The main function of HDL cholesterol is to carry cholesterol from the blood and tissues to the liver, where it can be removed from the body so it does not form arterial plaques (Circ Res, 2015;116(7):1133–1142). The prevention of arterial plaques is associated with higher levels of large HDL particles, not with the amount of total HDL cholesterol (Lancet, November 2022;85). People who have extensive plaques in their arteries have higher blood levels of small particle HDL (J Lipid Res, 2017;58(3):600–606). It is the large HDL particles that bind, neutralize and clear endotoxins and cholesterol from arterial plaques, not the small HDL particles (Innate Immun, 2021;27(1):3–14). Therefore, it is the large HDL cholesterol particles that dampen down overactive immunity (inflammation) that causes plaques to form in arteries and then break off to cause heart attacks (Handb Exp Pharmacol, 2015;224:483–508). A test for the concentration of large particle HDL may be more useful than than the standard tests for HDL, LDL and triglycerides that are ordered by most doctors.
Large particle HDL may be a predictor of longevity, but particle sizes appear to be genetic, and as far as we know today, cannot be improved with lifestyle changes or drugs.
The lifestyle factors associated with increased longevity include anything that uses your muscles or your mind. The more debilitated you are, the shorter your expected lifespan and the more active you are, the longer your expected lifespan.